2039 Incidence of Double Crush Syndrome in Lumbar Radiculopathy Patients With Distal Compression Sites

INTRODUCTION: Double Crush Syndrome (DCS) involves impingement at a proximal and distal site along a single nerve. While extensively studied in the upper extremity, DCS in the lower extremity remains under-investigated. Reported incidence rates among patients with upper extremity symptoms range from 6.7% to 73%, while there is no reported incidence rate for the lower extremity. As such, patients with lower extremity symptoms face uncertainty when facing a potential diagnosis of DCS, which may lead to delays in treatment and increased costs. METHODS: A retrospective cohort study was conducted on patients with concurrent lower extremity proximal and distal compressive symptoms from 2010-2022. The PearlDiver database was used to assess the incidence of DCS in the lower extremities among patients with International Classification of Diseases (ICD)-9/10 diagnostic codes and associated Current Procedural Terminology (CPT) codes. The incidence was calculated from the percentage of surgically treated patients with concomitant ICD/CPT codes relative to the total population. RESULTS: We identified 652 patients who met our study criteria. The majority of surgically treated patients were female (59.2%). The mean age of patients was 54.63 years, with the 55-59 age group having the highest incidence. The average payment per patient for DCS treatment was $3617.18. CONCLUSIONS: The incidence of DCS in the lower extremities was 53.93 per 100,000 treated patients. Despite a low incidence, the results underscore the need for increased research and education in this area. This is crucial in establishing clinically efficient and appropriate diagnostic criteria for lower extremity DCS. The implications of these findings may aid in reducing patient pain and distress, potential care costs related to delayed diagnosis, and improve overall patient outcomes.